The Vacuum Phenomenon in the Elbow: A Case Report

A 33-year-old man presented with a closed distal humerus fracture after a fall from scaffolding. Computed tomography demonstrated intra-articular gas, despite the lack of arthrotomy, open fracture, or skin defects. The "vacuum phenomenon" (VP), or the presence of intra-articular gas in closed injuries, has primarily been described in the axial skeleton. To our knowledge, there are no reports in fractures of the elbow.

The incidence of the VP is under-reported and represents a lack of physician awareness. The VP should remain a diagnosis of exclusion; however, physicians should be aware of this phenomenon to prevent unnecessary patient harm.